RIte @ Home is designed for individuals that require considerable assistance with the activities of daily living and cannot live alone. This program enables them to remain living in a home environment instead of a nursing home. Typically, the individual in need of care moves into the home of his or her “Caregiver.” Eligible caregivers are relatives and friends, but not spouses. Caregivers are required to provide all personal care services and be on call 24/7, though it is not expected they provide 24/7 care. For example, participants in this program can also receive adult day care.
Caregivers are paid for their efforts and supported by the Health and Human Services Office. They are provided with training, nursing support, respite, and monitored for the quality of care they provide. Intermediary agencies that manage many of the interactions with the state program exist and provide a valuable service. However, the host family (the caregivers) should expect the agency to take 30% – 40% for their services. At the time of writing, two agencies have been approved as intermediaries and it is required that program participants work with one of them.
Care recipients are expected to pay their caregiver for room and board from their SSI or Social Security checks. RI Medicaid does not pay for room and board.
This program is managed by the Executive Office of Health and Human Services (EOHHS) for RI Medicaid (Medical Assistance Program). One might hear it referred to as the Caregiver Homes Program or the Shared Living Program. It is now offered as a benefit under the Global Consumer Choice Compact Waiver.
Individuals must be unable to live independently and require considerable assistance with the activities of daily living. In addition, they must be financially qualified to receive Medicaid. RI Medicaid considers applicants’ income, assets and their history of asset transfers.
2022 Income Limit
A single individual can automatically qualify if his or her monthly income is below $2,523 per month. For married applicants, only the income of the applicant spouse is counted when applying for long-term care benefits. Married applicants with non-applicant spouses may transfer part, or in some cases, even all of their monthly income to their non-applicant spouses. As of January 2022, this amount may be as much as $3,435 / month and is called a monthly maintenance needs allowance. This is one way that an applicant can effectively lower his or her countable income while ensuring his or her non-applicant spouse has enough income from which to live. Applicants can also meet the Income Test if their income does not cover the cost of their monthly, recurring, medical expenses. Furthermore, individuals with annual income over the limit may also qualify, but will have a share of cost contribution that the state Medicaid office sets based on their income.
2022 Asset Limit
Single applicants are permitted to retain up to $4,000 in countable assets. If an applicant is married and his or her spouse is not receiving Medicaid assistance, the non-applicant spouse can retain up to $137,400 of the couples’ joint assets. This rule is in place to prevent the non-applicant spouse from becoming impoverished and is called the community spouse resource allowance. The value of the couples’ place of residence, provided the equity value does not exceed $636,000, is not counted towards the Medicaid asset total. However, since this program entails alternative housing for seniors with a functional need, their home would not be owner-occupied and would count as an asset, if a spouse were not living in it.
Past Asset Transfers
Asset transfers and gifts made by the Medicaid applicant for up to 60 months preceding his or her date of application may be reviewed. This is to ensure they were not given away or sold under market value with the simple goal of reducing total assets to qualify for Medicaid. This is referred to as the Medicaid Look Back Period. Additional details are available here.
For those unsure of their eligibility status, assistance is available.
Caregivers provide all personal care, meals, homemaker services and chores, transportation, socialization, and are on call 24/7. Agencies will provide respite care to the caregiver. Adult day care is also available for those participants whose caregivers are unable to be available 24/7. Note that using adult day care reduces the caregivers’ compensation by approximately 15%.